Ask the Doctor

From Brett:-
I had a no scalpel vasectomy 21 days ago. During the surgery, I remember distinctly having a sharp pain on the left side. I’ve been in pain on the left side only ever since. On day 5 (a Saturday), the pain was severe enough that I had the on-call urologist paged. He prescribed antibiotics (Levaquin) for 10 days over the phone. On day 7, while sitting at work all day in front of a computer, the pain became unbearable again, and I scheduled an appointment with the
urologist who performed the vasectomy. He seemed very nonchalant, and told me that some people have pain for years. He then prescribed naproxen 500mg and Elavil. I have been on the naproxen ever since, but have not taken the Elavil. I’m not a big fan of altering brain chemistry “off the cuff”. I did 8 of 10 days of the Levaquin, but when I accidentally missed a day, I discontinued them (my urologist had told me he didn’t think it was an infection anyway). Anyway, the pain seems to be on the back of my left testicle, but after sitting for a while it
tends to move up into my groin and abdomen. I have had a couple “good days”, and have swam and run on these days. Two days ago I tried cycling, during which I only experienced slight occasional pain in my left testicle. However, yesterday and today I have been in a lot of
pain that seems a little different in that it seems more up away from the testicle in the groin (although my testicle is still sore also). So I’m wondering if sometimes it is normal for “recovery” to be this long, and whether or not I should follow up again with the urologist. I don’t
want to seem like a “whiner”, but it is fairly debilitating in that I can’t sit for very long and I can’t cycle or run consistently.

Pain in the testicle immediately after a vasectomy in an otherwise uncomplicated procedure is usualy related to inflammation and equillibration of the epididymis. Inflammation is associated with any form of trauma, infection or surgery. The inflammation can persist for weeks or months if it is not appropriately treated with rest, anti-inflammatories (at least 3 weeks) and warm bath soaks. Prolonged periods of sitting or performing exercise without adequately supportive underwear can exacerbate the condition. The second reason is that immediately after a vasectomy, the epididymis goes through and equillibration phase. Sperm that was once released periodically becomes trapped in the epididymis causing the organ to become engorged with sperm. Once the sperm die, they are reabsorbed by the epididymis. Nobody knows for sure how long this process takes, but it can last for a few weeks to months.